Panel: "Leadership and Innovation in Healthcare Delivery"
By Puja Upadhyay
On Wednesday, October 22nd, four leaders in hospital administration spoke to the Wharton Undergraduate Healthcare Club about their experiences in the rapidly changing hospital environment: Michael Rossi, Director of Government Reimbursement at Penn Medicine, Craig Umscheid, Director of the Center for Evidence-Based Practice at Penn Medicine, Paula Stillman, former Vice President of Health Care Services for Temple University Health System and Joni Rittler, VP of Supply Chain at The Children’s Hospital of Philadelphia. Each of these professionals provided a unique outlook on the current and future state of hospitals and the many opportunities for leadership and innovation in the field of hospital administration in a Q&A discussion panel.
While Dr. Stillman and Dr. Umscheid have extensive medical educations, Mr. Rossi did not immediately know he would end up playing a vital role in Penn Medicine’s financial system. He graduated with a bachelor’s degree in accounting and spent a few months in a small accounting firm, until he was asked to go on an audit of a hospital, which “launched [his] healthcare career.” Similarly, Mrs. Rittler has been in supply chain for twenty years, but as she explained, “you don’t grow up wanting to be in supply chain, you just sort of fall into it.” Her degree is in information technology, but it didn’t take her long to realize that a career in computer science wasn’t for her, although the skills she learned were useful as she made her way to CHOP.
Since there have been so many changes in the delivery of care due to the ACA, each of the panelists discussed how these changes have influenced their day-to-day work. For Dr. Umscheid, the biggest impact has been new programs that reward good performance and penalize bad performance. Additionally, meaningful use of health IT has also made a large impact. A lot of time is spent making sure health IT systems have particular data elements and functionalities. Dr. Umscheid stressed that electronic health records are “still in the stone ages, but the potential is there.” This federal legislation has made a substantial effect on how the health system spends money, which was also addressed by Mrs. Rittler. Cutting costs often means cutting supplies and services, rather than reducing the number of physicians. The ACA has impacted how money is being spent by forcing hospitals to be cost effective and cost competitive. Mr. Rossi emphasized that much of the focus of the ACA has been to drive costs out of the system. His one issue with the actis that it “attempts to change patterns and reduce costs by reducing payments [to hospitals]”. These payments are oftentimes determined by the number of readmissions within a certain timeframe. Regardless of the fact that some hospitals had fewer readmissions than they did the previous year, their penalty went up because their number was higher than that of other hospitals.” At the same time, these penalties are driving clinicians and financial advisors to invest more in better quality of care initiatives. Dr. Stillman also commented on the serious misuse of diagnostic tests, emergency room services, and problems of quality that still need to be addressed.
The panelists also discussed what is currently lacking in medical education. Dr. Umscheid explained that there should be more emphasis on clinical decision making, medical epidemiology, quality improvement methods, and patient centeredness, all areas that “are lacking in pretty extreme ways.” The focus is more often on the standard hard sciences, such as biochemistry and anatomy, which in the modern world would not translate effectively for someone who wants to go out and practice. However, he explained, “We’re in the midst of a major evolution [of medical education], but we’re not quite there yet.”
When asked why the panelists are still involved in and excited about health care, all of them emphasized that the job is “never dull” and they are “contributing to something meaningful that impacts lives in a common way.” They also agreed that hospitals provide opportunities for people with a variety of skill sets,, not only clinical, which allows them to work with various departments all “in a common pursuit” to better the quality of health care that every individual receives.